While antibiotics are prescribed in the treatment of a severe bacterial infection, one has to be conscious while using the same for an elderly individual, say experts. Why so? Because, there are possibilities of side effects of antibiotics in the elderly, which is a cause of concern.
“There is fear that elderly people can easily become sick so they are given too many antibiotics,” says Dr Ravikiran Barigala, infectious diseases specialist, Apollo Health City Jubilee Hills, Hyderabad, Telangana. He adds that there are definitely a lot of concerns for elderly persons taking too much antibiotics. Dr Barigala mentions, “This can result in more side effects, general weakness, possibilities of weaker immunity, drug resistance.” Plummeting hormone levels in the elderly can cause low immunity.
Some senior citizens are conscious about the medicines. Bengaluru based elderly couple, Jayaram N (68), and Bhanumathi (65), say that both of them rarely fall sick as they carefully take care of their health and use medicines judiciously. “Unless the illness is prolonged, which is a rare occurrence, we avoid antibiotics.” The couple follows a healthy lifestyle with nutritious, freshly cooked food and regular walk, Yoga, and good night’s sleep.
Know the side effects of antibiotics in elderly
Inadvertent use of antibiotics or overuse of drugs can be harmful. One must know the side effects of antibiotics in elderly, says Dr Srividya S, consultant, Internal Medicine, Manipal Hospital, Yeshwanthpur, Bengaluru.
Dr Raj Shankar Ghosh, physician from New Delhi points out that elderly individuals benefit from antibiotics and other medicines when they need to fight infections. “But the issue arises when antibiotics are prescribed as preventive medicines. This was true during Covid-19 pandemic when most elderly were prescribed antibiotics (as prophylaxis). Medical experts presumed this prevented them from being infected by Covid-19,” points out Dr Ghosh.
In 2019, CDC report on Antibiotic Resistance Threats in the United States stated, nearly 30% (47 million) antibiotics courses prescribed by U.S. medical experts to the general population were unnecessary. Experts strongly recommend elderly must avoid indiscriminate use of antibiotics.
Many fall for the pseudo sense of protection that antibiotics offer and end up using self-medication, which the doctors warn against.
The genuine, safe use of antibiotics is to treat bacterial infections. Also, antibiotics help to prevent infections during surgery, organ transplants, chemotherapy, sepsis states Centers for Disease Control and Prevention (CDC).
Antibiotics for bacterial infection, not viral
Dr Srividya differentiates, “Antibiotics are effective only for bacterial infections, not for viral infections.” One must take antibiotics only when there is bacterial infection and only after medical consultation, she adds.
The other obvious method is to avoid bacterial infections, says Dr Srividya. Keeping oneself and others healthy by practicing good hand hygiene and healthy food habits helps, she adds.
Gurmeet Singh (57), Professor and Head of Center for Ayurveda Biology and Holistic Nutrition at The Trans-Disciplinary University (TDU), Bengaluru explains that he learnt the side-effects associated with antibiotic usage only when he started reading about gut microbiome. “When young I used antibiotics for faster recovery and I could not take a day off work. But now, it’s not the same. Now, being aware, antibiotics are my last resort,” said Singh.
Side effects of excess antibiotics usage among elderly
Disruption of good and bad bacteria: The body is made up of good bacteria (healthy microbiome) and bad bacteria. “Antibiotics not just act on harmful bacteria but also affect the good ones, thus disrupting the balance,” explains Dr Srividya.
Drug interactions: The drug interactions (which arise out of taking more than one medicine at a time) also become unpredictable in the body, says Dr Barigala, adding that consuming too many antibiotics can reduce immunity in the population, causing a general weakness.
Drug Dependency: One of the predominant dangers of overuse of antibiotics is dependency, warns, Dr Barigala. “Frequent and long-term use of antibiotics becomes a vicious cycle. Dependency leads to frequent infection without use of antibiotics, and this forces elderly to use antibiotics to prevent infections.”
Antibiotic resistance: Dependency could give rise to antibiotic resistance (the bacteria or germs do not get killed by the drugs and continue to grow) and this can be dangerous, say experts. The emergence of antibiotic-resistant strains of bacteria (such as multidrug-resistant Mycobacterium tuberculosis -MDRTB) are the primary adverse consequences, says Dr Srividya.
“Other than antibiotic resistance, antibiotic-resistant strain results in prolonged illnesses, the need for newer and stronger antibiotics and alternative treatments,” she adds.
The safe use of antibiotics
“Every antibiotic has a regimen. It should be taken as prescribed without any alterations in the dose, course, interval,” cautions Dr Ghosh. “This can avoid emergence of resistant strains,” adds Dr Srividya. Staying hydrated while on antibiotics is vital to prevent liver and kidney issues, stresses Dr Ghosh.
What can we do to avoid antibiotic misuse?
Dr Srividya lists down the ways to avoid antibiotic misuse:
- Do not self-medicate antibiotics or buy over the counter.
- Take antibiotics only when applicable, like, to be used only in case of bacterial infection and not viral
- Stick to the prescribed doses only. Do not alter the dose, interval, or course of the treatment.
Takeaway
- Antibiotics treat bacterial infections and should be used on the recommendation of a doctor only.
- The use of antibiotics as preventive medicine could easily lead to their overuse, say experts.
- The side-effects of antibiotic overuse include reduced immunity, disruption of good and bad bacteria, drug interactions, dependency and antibiotic resistance.
